REPAIR-ICU Lab
Understanding why some patients bounce back after critical illness — and why others don't.
#About
Every year, millions of patients survive sepsis and critical illness, but survival is only the beginning of the story. Many survivors experience accelerated aging, recurrent hospitalizations, and declines in function and quality of life that persist long after the ICU. We are the REPAIR-ICU Lab at the University of Pittsburgh and VA Pittsburgh Healthcare System, led by Florian Mayr, MD, MPH. We study the biology and epidemiology of recovery after critical illness: why trajectories diverge, which mechanisms drive inflammaging and cellular senescence in survivors, and how health systems can deliver high-quality post-ICU care. Our work spans molecular epidemiology, national VA and Medicare data, adaptive platform trials, and EHR-embedded informatics, supported by the National Institute of General Medical Sciences (R35 GM166313) and the Department of Veterans Affairs.
#Research
The core of our NIGMS-funded R35 program: longitudinal blood-based measures of epigenetic age, inflammation, and cellular senescence in sepsis survivors, to define the mechanisms of accelerated biological aging after critical illness — and ultimately targets to slow it.
From our Post-Acute Recovery Center (PARC) at VA Pittsburgh to national analyses of VA and community care, we study how survivors navigate care after the ICU, where follow-up breaks down, and how scalable recovery programs (SPARC/SPARCLE) can deliver consistent, high-quality care to every survivor.
As part of the international REMAP-CAP platform trial, we help design and monitor adaptive, Bayesian trials that learn as they go — including the immunomodulation domain that changed global COVID-19 care.
EHR-embedded prediction models for sepsis and readmission, ICU quality dashboards, and human-centered decision support — making recovery science usable at the bedside and across a national health system.
#Featured Papers
Using national VA data, we mapped where Veterans actually receive ICU care — inside VA hospitals versus purchased community care — with direct implications for how the VA plans, staffs, and pays for critical care. (Team-led: Zachary Hahn)
Comparing post-ICU care trajectories after VA versus community hospital discharges, this CHEST paper shows how fragmented follow-up shapes outcomes for Veterans — motivating our SPARCLE program of scalable recovery care. (Team-led: Zachary Hahn)
Do sepsis phenotypes actually change treatment decisions? Victor Talisa compared phenotype-based and individualized absolute-risk approaches in two multicenter trials, sharpening how precision medicine should be operationalized in sepsis. (Team-led: Victor Talisa)
#Journal Club — What We're Reading
Recent high-impact papers in biomonitoring and longevity — pulled from the lab's Zotero collections, with our takes.
#Recent Publications
- Yende S, Talisa VB, Mayes K, Williams K, Malito A, Mayr FB, Angus DC, Awdish R, Liang Q, Rak KJ, et al. Remote Monitoring Approaches to Reduce Readmissions After Infection and Sepsis: A Randomized Clinical Trial. JAMA Netw Open. 2026. PMID: 42275060.
- Hahn Z, Tyler B, Atwood C, Hotchkiss JR, Mayr FB. Post-Intensive Care Fragmentation Among Rural Veterans: Transitions Between VA and Community Health Systems. J Rural Health. 2026. PMID: 42233317. TEAM-LED
- Venkatesan N, Shah FA, Bain W, Yang Z, Dela Cruz CS, Baron RM, Zuchelkowski B, Rizzo AN, Joshi S, …, Mayr FB, et al. Risk heterogeneity within hypoinflammatory acute respiratory failure: continuous probabilities identify high-risk patients masked by binary classification. Intensive Care Med. 2026. PMID: 42043553.
- Olszewski AE, Butler RA, Ashana DC, Carson S, Cox CE, Hough CL, Hwang DY, Maloney D, Mayr F, Menon V, et al. Protocol for a randomized trial of a scalable, interactive tool to support surrogate decision-makers of critically ill patients. Contemp Clin Trials. 2026. PMID: 41730449.
- Naiditch H, Talisa VB, Magnani JW, Nouraie SM, Yende S, Mayr FB. Racial and Ethnic Inequalities Among Survivors of Critical Illness in the MIMIC-IV Database. J Intensive Care Med. 2026. PMID: 41295887.
- Hahn Z, Naiditch H, Brucato MF, Talisa V, Tyler B, Hotchkiss JR, Yende S, McVerry BJ, Mayr FB. Post-ICU Care Trajectories and Outcomes Among Veterans: Comparing Veterans Affairs and Community Hospital Discharges. Chest. 2026. PMID: 41110691. TEAM-LED
- Hahn Z, Naiditch H, Talisa V, Tyler B, Hotchkiss JR, McVerry BJ, Yende S, Mayr FB. Intensive Care Unit Admissions Purchased or Delivered by Veterans in the VA Health Care System. JAMA Health Forum. 2025. PMID: 41385207. TEAM-LED
- Naiditch H, Talisa VB, Magnani JW, Nouraie SM, Yende S, Mayr FB. Identifying racial inequalities in long-term outcomes among survivors of critical illness with sepsis in a US cohort: a retrospective cohort study. BMJ Open. 2025. PMID: 41290296.
- Inman K, Chernus J, Lee M, Alder JK, Shah FA, Mayr FB, Dempsey T, Nouraie SM, Dela Cruz C, Ferreira VP, et al. Genetic Variation in the Alternative Complement Pathway Contributes to Individual Susceptibility to Bacteremia and Sepsis. Crit Care Explor. 2025. PMID: 41165296.
- Talisa VB, Yende SP, Angus DC, Bellomo R, Chang CH, Cooper GF, Harrison DA, Higgins A, Kennedy JN, Mayr FB, et al. Relationship Between Phenotyping and Individualized Absolute Risk Differences in Sepsis: A Secondary Analysis of Two Approaches in Two Multicenter Trials. Crit Care Explor. 2025. PMID: 41098209. TEAM-LED
Complete list (93 PubMed-indexed):
full CV ·
Google Scholar ·
ORCID
Publication list refreshes automatically from PubMed (2026-08-17).
#Talks
Upcoming
posit::conf(2026) · Houston, TX
UPMC McKeesport · McKeesport, PA
Recent
Sepsis Alliance · Washington, DC
University of Washington · Seattle, WA
#People
Associate Professor of Critical Care Medicine at the University of Pittsburgh; intensivist and physician-scientist at VA Pittsburgh, where he directs the Post-Acute Recovery Center (PARC) and serves as Assistant VP for Education and Research of the critical care service line.
Medical Director of the Special Care Unit at VA Maine (Togus) and Assistant Research Professor of Medicine, University of Maine Orono. Dual-boarded in emergency and critical care medicine with graduate training in health informatics; first author on the group's recent JAMA Health Forum and CHEST papers.
Assistant Professor of Critical Care Medicine and Biostatistics, University of Pittsburgh. Works on identifying patient subgroups in clinical trials, causal inference and machine learning, adaptive trial design, and sepsis phenotyping; methodological lead across the lab's cohort studies and the ACCOMPLISH adaptive trial.
Collaborators: Sachin Yende, MD, MS (University of Pittsburgh) · Bryan McVerry, MD (University of Pittsburgh, Pulmonary, Allergy & Critical Care Medicine) · Pittsburgh Acute Lung Injury Registry (ALIR) Group (University of Pittsburgh / UPMC)
#News
Dr. Mayr presents the lab's ICU quality dashboard work at posit::conf in Houston, September 14–16.
Zachary Hahn's new analysis in the Journal of Rural Health tracks how rural Veterans move between VA and community health systems after intensive care, and where continuity of care breaks down along the way.
The lab's five-year program on recovery, epigenetics, and inflammaging after critical illness (R35 GM166313, $1.9M) begins August 2026.
Dr. Mayr spoke on long-term outcomes after sepsis and the case for post-ICU recovery care at UW Medicine Grand Rounds in Seattle.
Zachary Hahn's analysis of ICU admissions purchased or delivered by the VA appears in JAMA Health Forum.
#Funding
- NIH/NIGMS R35 GM166313 — Recovery, EPigenetics and Inflammaging Research after Critical Illness (2026–2031)
- U.S. Department of Veterans Affairs — Complement Factor H in Severe Pneumonia (I01 BX006614, Co-I, 2026–2029)
- Previously: NIH/NIGMS K23 GM132688, VA VISN-4 CDA, VHA Office of Health Equity, PCORI (ACCOMPLISH)